Incontinence is a condition in which there is uncontrolled release of natural discharges or evacuations. While some forms of incontinence are more widespread, the condition usually affects women, the elderly and the infirm. Urinary incontinence refers to loss of bladder control resulting in involuntary or uncontrolled urination. Other forms of incontinence including faecal or bowel incontinence also exist. In the context of the present application, the term “incontinence” is to be taken to include urinary and faecal incontinence.
Incontinence, in the context of this specification, includes urinary and faecal incontinence, and management of such incontinence is to be seen in the context of persons located in hospitals, nursing homes, aged care facilities, geriatric institutions, private homes and the like.
The aforementioned incontinence, when unchecked, may result in the person suffering from the condition experiencing discomfort or at least embarrassment, and in the existence of unpleasant odours and environment for others in the vicinity of the person. In addition, health regulations or protocols may prescribe a maximum period, such as 15 minutes, for which a patient may be left in a wet state caused by incontinence. In the past, to comply with such requirements, it has been necessary for nursing staff to manually check each patient at least once during the prescribed period. Apart from the unpleasantness experienced by nursing staff in carrying out such manual checks, such a regimen may place a severe strain on staff resources, and may constitute an interruption to patients' rest and sleep.
A range of different incontinence types are recognised. Stress incontinence refers to involuntary loss of urine immediately associated with coughing, sneezing, lifting, straining or other physical exertion. The term “stress” relates to the mechanical stress of the abdominal muscles compressing the bladder wall, working against weakened sphincter muscles. Childbirth, obesity, constipation and changes in the sphincter muscles after the menopause can aggravate stress incontinence as can the use of some drugs.
Urge incontinence refers to the involuntary loss of urine coupled with a strong desire to urinate. Often the sufferer is unable to reach the toilet before there has been a urine loss. The need to visit the toilet may occur very frequently during the day and often at night also. Urge incontinence is generally caused by an overactive or “unstable” bladder which contracts involuntarily in an attempt to empty. The contractions give rise to an urgent desire to pass urine and uncontrolled leakage occurs before a toilet is reached. Mixed Urinary Incontinence (MUI) refers to involuntary leakage associated with urge incontinence and also with exertion, effort, sneezing, or coughing associated with stress incontinence.
Overflow incontinence refers to involuntary loss of urine associated with a chronically distended and overfull bladder. The bladder may be distended as a result of incomplete emptying which may be caused by obstruction to the outlet of the bladder or as a result of a failure of the bladder muscle to contract properly. Bladder failure of this kind may be caused by disease of the nervous system, by some drugs or by psychological factors.
Dribble incontinence refers to leakage of urine without warning or provocation. This is a demoralising condition because leakage can occur at anytime and is unpredictable. Persons suffering from dribble incontinence often need to wear protective pads or diapers throughout the day and night. Total incontinence is a term sometimes used to describe continuous leaking of urine, day and night, or periodic large volumes of urine and uncontrollable leaking. Some people have this type of incontinence because they were born with an anatomical defect. It can also be caused by a spinal cord injury or by injury to the urinary system from surgery.
Functional incontinence occurs where the ability to get to the toilet is impaired either by physical conditions such as paralysis or arthritis, or mental impairment. This is very common in nursing home patients who rely on assistance from others for mobility.
Although incontinence is relatively widespread, it is a condition which must be treated with sensitivity as it can be uncomfortable and embarrassing for sufferers and carers alike. When left unchecked, incontinence can become more embarrassing due to the existence of unpleasant odours associated with incontinence events and this can create an unpleasant environment for others in the vicinity of the incontinence sufferer. In addition, exudate escaping the body as the result of an incontinence event often contains bacteria, so unchecked wetness can create health and hygiene problems. Also, health regulations or protocols may prescribe a maximum period, for example 15 minutes, for which a patient suffering incontinence may be left in a wet state.
In the past, to comply with regulations and protocols and to ensure that patients in care institutions such as hospitals, nursing homes, aged care facilities and geriatric institutions are well looked after, it has been necessary for staff to manually check patients suffering from incontinence on a regular basis. Apart from the unpleasantness involved with manual checks, such a regimen also places a strain on staff resources. Often manually checking for wetness will also cause interruption to a patient's rest and sleep.
Incontinence indicators and detection systems exist. However, they have done little to improve the current situation in which carers must manually and regularly check patients for wetness. Existing incontinence detection systems are generally unable to distinguish a urinary incontinence event from a fecal incontinence event or the size of these events. Existing systems are also deficient in that they alarm or alert a carer simply when wetness is detected, with no indication of the degree of wetness present. This can cause more time wasted than saved as very small volumes e.g. of urine or perspiration may trigger an alert even though the patient does not actually require attention from a carer. This can also be a source of embarrassment for the patient.
Some systems involve complicated circuitry and are expensive and difficult to manufacture. Since most diapers and pads are disposable both for efficiency of use and hygiene reasons, complicated sensor systems do not lend themselves to widespread uptake and ongoing use.
Some systems are clumsy to use and the sensors can interfere with the absorbent capacity of the diaper or pad with which they are used. Others again are generally incompatible with current care practices and actually create additional work, significant complications or changes in care practices undermining any benefits they may offer and making them less susceptible to widespread uptake and ongoing use.
The present invention aims to improve upon these systems, to improve efficiency in monitoring and management of continence with minimal changes in care practices, or at least provide a useful alternative to existing systems.